Basic Burr Holes

A good place to start is with the 3 standard basic burr holes.

The position of each can be marked on one side of the head, and then the scalp incised, gently dissected free of the underlying bone, and Raney clips attached to the skin edges.

Place a small self-retaining retractor to expose the bone and then each of the 3 burr holes can be drilled

The 3 standard holes are;

• Frontal; in the mid pupillary line 1” behind the hairline
• Temporal; 1” in front and 1” above the external auditory meatus.
• Parietal; directly over the parietal eminence.

Ensure that the skin incisions for each of these are on a line that could be joined up, if necessary, to make a standard ?-mark shaped flap.

Different burrs.

There are a number of different burrs and perforators that can be used, as well as the compressed air powered craniotome with reduction gear.

• Standard Burr
• Rose Burr
• Conical Burr

Each will produce a slightly differently profiled burr hole, and some will protect the dura better than others.

Once the burr hole has been made the underlying dura can be opened in a cruciate fashion to expose the brain.